<cfoutput>
	#dspDocumentHeader()#
	<h2>Controlled Substance Medication Log</h2>
	<form>
		<cfif PARAMS.key NEQ 0>#dspFormButtons(key=PARAMS.key, action=PARAMS.controller)#</cfif>
		<fieldset>
			<ol>
				<li>Use one form for each controlled substance medication.</li>
				<li>Count units upon receipt at each change of shift and at discharge.</li>
				<li>Consumer must co-sign monitoring.</li>
			</ol>			
			<table width="100%">
				<tr>
					<cfloop list="Drug Name/Dosage/Frequency,Initial Quantity,RX Number,Expiration Date" index="Label">
						<td class="left"><input type="text" /></td>
					</cfloop>
				</tr>
				<tr>
					<cfloop list="Drug Name/Dosage/Frequency,Initial Quantity,RX Number,Expiration Date" index="Label">
						<th class="left">#Label#</th>
					</cfloop>
				</tr>
			</table>
			
			<table class="forms" cellpadding="3">
				<tr>
					<cfloop list="Date,Time,## Given,## Units Remaining,Consumer	Staff,Co-Signature (Change of Shift),Comments" index="Lebel">
						<th>#Label#</th>
					</cfloop>
				</tr>
				
				<tr>
					<cfloop list="Date,Time,## Given,## Units Remaining,Consumer	Staff,Co-Signature (Change of Shift),Comments" index="Lebel">
						<th><input type="text" /></th>
					</cfloop>
				</tr>
			</table>
			
			<table width="100%" cellpadding="3">
				<tr><td colspan="8">Quantity Discharged: <input type="text" /></td>
				<tr>
					<cfloop list="Staff Initials,Consumer Initials,Date,Time" index="Label">
						<td>#Label#: </td><td><input type="text" /></td>
					</cfloop>
				</tr>
			</table>
		
			<h4>Consumer Name: <span style="font-weight: normal;">#Consumer.firstName# #Consumer.lastName#</span></h4>
		</fieldset>
		<cfif PARAMS.key NEQ 0>#dspFormButtons(key=PARAMS.key, action=PARAMS.controller)#</cfif>
	</form>
</cfoutput>